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Efficacy and Mechanism of buxue yimu pillson Gynecological Anemia:A Combination of Clinical and Network Pharmacology Study

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Chinese Journal of Integrative Medicine 2022年第12期28卷 1072-1080页

作者： WANG Yan-fang DENG Yan ZHANG Su-ying LIU Dong LUO Bin WANG Xue DENG Miao MA Rui-lin SUN Ai-jun Department of Obstetrics and Gynecology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Obstetrics and Gynecology the Second Affiliated Hospital of Hunan University of Chinese MedicineChangsha 410001China West China Second Hospital Key Laboratory of Birth Defects and Related Diseases of Women and ChildrenSichuan UniversityMinistry of EducationSichuan UniversityChengdu 610041China Department of Obstetrics and Gynecology Hangzhou Women's Hospital(Hangzhou Maternity and Child Health Care Hospital)Hangzhou 310008China

Objective:Tocompare the clinical efficacyand safety of oral administration of buxueyimupills(BYP),ferrous sulfate(FS),and the combination of BYP and FS on gynecological anemia,and investigate the mechanisms using network pharmacology.Methods:A randomized,controlled,multi-center clinical trial was conducted.Totally 150 patients with hemoglobin of 70-110 g/L due to gynecological conditions were recruited and randomized(using the block randomization method)into buxue yimu pills group(24 g/d),oral iron group(FS Tablets,0.9 g/d),and combined treatment group(BYP,24g/d plus FS Tablets,0.9 g/d),50 patients in each group.At the enrollment and 4-week treatment,complete blood count,serum iron indexes were evaluated.Adverse events,liver and renal functions,as well as blood coagulation were observed.Network pharmacology was conducted to identify the active ingredients and explore the potential mechanisms of BYP.Results:Ten(20%)and 7(14%)participants discontinued the therapy due to gastrointestinal symptoms in oral iron and combination treatment groups.All 3 groups showed elevated hemoglobin.The patients in the iron group exhibited typically elevated in serum iron and ferritin and decreased in total iron-binding capacity.No change in iron indexes was observed in BYP group.The patients in the combination treatment group neither showed significant changes in serum ferritin nortotal iron-binding capacity.No significant adverse reactions were observed in the BYP group.The network pharmacology identified 27 bioactive compounds and 145 targets of BYP on gynecological anemia.Biological processes and pathways including regulation of inflammation,hormone,angiogenesis and hemostasis,responsetodecreased oxygen levels,effects on myeloma cell,and responseto metal ions were identified.Conclusion:BYP contributes to the practical improvement on gynecological anemia potentially through multi-target mechanisms and optimized iron re-distribution.

关键词： Chinese medicine buxue yimu pills gynecological anemia network pharmacology multi-target mechanism

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